Metle
Generic Name
Metformin Hydrochloride
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| metle 500 mg tablet | ৳ 4.00 | ৳ 40.00 |
Description
Overview of the medicine
Metformin is an oral antidiabetic medication used to manage type 2 diabetes mellitus. It helps to lower blood sugar levels by decreasing glucose production in the liver, reducing glucose absorption from the intestines, and improving the body's sensitivity to insulin.
Uses & Indications
Dosage
Adults
Initial dose: 500 mg orally twice daily with meals. May be increased gradually by 500 mg weekly to a maximum of 2500 mg daily in divided doses. For sustained-release formulations, typically 500-1000 mg once daily with the evening meal, maximum 2000 mg daily.
Elderly
Start with a lower dose (e.g., 500 mg once daily) and monitor renal function closely due to the potential for decreased renal function in the elderly.
Renal_impairment
eGFR 60-90 mL/min: No dose adjustment. eGFR 45-59 mL/min: Max dose 2000 mg/day, monitor eGFR every 3-6 months. eGFR 30-44 mL/min: Max dose 1000 mg/day, monitor eGFR every 3 months. eGFR <30 mL/min: Contraindicated.
How to Take
Take Metle 500 mg tablet orally with meals, typically twice daily. Taking it with food helps reduce gastrointestinal side effects. Swallow the tablet whole; do not crush, chew, or break extended-release tablets.
Mechanism of Action
Metformin primarily acts by decreasing hepatic glucose production (gluconeogenesis and glycogenolysis) and reducing intestinal absorption of glucose. It also improves insulin sensitivity by increasing peripheral glucose uptake and utilization. It does not stimulate insulin secretion and therefore does not cause hypoglycemia in monotherapy.
Pharmacokinetics
Onset
Onset of action typically within 1-2 hours, with full therapeutic effect seen in several days to weeks.
Excretion
Renal excretion is the primary route. Approximately 90% of the absorbed drug is eliminated via the renal route within 24 hours.
Half life
Plasma elimination half-life is approximately 4-9 hours. In whole blood, the half-life is approximately 17.6 hours.
Absorption
Absolute bioavailability is approximately 50-60% after an oral dose. Food decreases the extent and slightly delays the absorption of metformin.
Metabolism
Metformin is excreted unchanged in the urine; it does not undergo hepatic metabolism (no CYP450 involvement) nor biliary excretion.
Side Effects
Contraindications
- •Severe renal impairment (eGFR <30 mL/min/1.73 m²)
- •Metabolic acidosis, including diabetic ketoacidosis, with or without coma
- •Hypersensitivity to metformin hydrochloride or any component of the formulation
- •Acute or chronic metabolic acidosis (e.g., lactic acidosis)
Drug Interactions
Alcohol
Potentiates the effect of metformin on lactate metabolism, increasing the risk of lactic acidosis, especially in fasting or malnourished patients.
Iodinated contrast agents
Temporarily discontinue metformin before or at the time of the procedure and for 48 hours afterward in patients with an eGFR between 30 and 60 mL/min/1.73 m², those with a history of liver disease, alcoholism, or heart failure, or those who will be administered intra-arterial iodinated contrast agents. Re-evaluate eGFR after the procedure and restart metformin if renal function is stable.
Diuretics (e.g., Thiazides, Loop diuretics)
May increase blood glucose levels, potentially leading to loss of glycemic control.
Corticosteroids, Sympathomimetics, Phenothiazines
Can increase blood glucose levels, requiring dose adjustment of metformin.
Cationic drugs (e.g., Cimetidine, Ranitidine, Amiloride)
May increase metformin plasma concentrations by competing for renal tubular transport.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Metformin overdose can lead to lactic acidosis, which is a medical emergency and must be treated in a hospital. Symptoms may include extreme tiredness, severe muscle pain, trouble breathing, stomach pain, dizziness, and a fast or slow heart rate. Treatment involves hemodialysis to remove metformin and correct acidosis.
Pregnancy & Lactation
Pregnancy Category B. Limited data on metformin use in pregnant women are insufficient to determine a drug-associated risk of major birth defects or miscarriage. However, uncontrolled diabetes in pregnancy is associated with risks. Metformin is excreted in human breast milk; caution should be exercised when administered to a nursing woman.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24-36 months from the date of manufacture, depending on storage conditions.
Availability
Pharmacies nationwide
Approval Status
Approved by regulatory authorities
Patent Status
Generic available
WHO Essential Medicine
YesAlternative Medicines in Bangladesh
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Global Brand Names
International brand names for this medicine
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